Evidence map›Paper›PMID 21617090›Full record

Trial reportClinical journal of the American Society of Nephrology : CJASN2011

A nurse-coordinated model of care versus usual care for stage 3/4 chronic kidney disease in the community: a randomized controlled trial.

Brendan J Barrett, Amit X Garg, Ron Goeree, Adeera Levin, Anita Molzahn, Claudio Rigatto, Joel Singer, George Soltys, Steven Soroka, Dieter Ayers and 1 more

2 registry-linked trialsAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical journal of the American Society of Nephrology : CJASN, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 38 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 6 pooled it
5.4field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01446029 phase3completednot on this mapstarted 2012, after this paper: background citation

Telemonitoring to Improve Outcomes of Patients With Chronic Kidney Disease

TypeinterventionalSponsorMinneapolis Veterans Affairs Medical CenterRan2012 to 2013Enrolled601ConditionsChronic Kidney DiseaseArmsVideo Telemonitoring Device with Clinical Care Modules
NCT01978951 nacompletednot on this map

Effectiveness of Integrated Care on Delaying Chronic Kidney Disease Progression in Rural Communities of Thailand (ESCORT Study)

TypeinterventionalSponsorBhumirajanagarindra Kidney Institute, ThailandRan2011 to 2013Enrolled443ConditionsChronic Kidney DiseaseArmsIntegrated Chronic Kidney Disease care, Conventional CKD care
3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 6 syntheses or guidelines pooled it, 108 citations in OpenAlex.

  1. Pooled it
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  12. Nurse practitioner care improves renal outcome in patients with CKD.Journal of the American Society of Nephrology : JASN · 2014
    Trial
  13. Effect of shared care on blood pressure in patients with chronic kidney disease: a cluster randomised controlled trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2013
    Trial
  14. Cost-effectiveness analysis of a randomized trial comparing care models for chronic kidney disease.Clinical journal of the American Society of Nephrology : CJASN · 2011
    Trial
  15. Article
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  18. Nurse Practitioner Care Compared with Primary Care or Nephrologist Care in Early CKD.Clinical journal of the American Society of Nephrology : CJASN · 2023
    Article
  19. Observational
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 9 institutions in 1 country.

Brendan J BarrettMemorial University of Newfoundland, St. John's, Newfoundland, Canada. bbarrett@mun.ca
Amit X Garg
Ron Goeree
Adeera Levin
Anita Molzahn
Claudio Rigatto
Joel Singer
George Soltys
Steven Soroka
Dieter Ayers
Patrick S Parfrey
Memorial University of Newfoundland · CAUniversity of British Columbia · CACanadian Institutes of Health Research · CADalhousie University · CAHôpital Charles-Le Moyne · CAMcMaster University · CAUniversity of Alberta · CAUniversity of Manitoba · CAWestern University · CA

Funding

Canadian Institutes of Health Research
6 · The paper itself

Abstract

BACKGROUND AND

objectivesIt is unclear how to optimally care for chronic kidney disease (CKD). This study compares a new coordinated model to usual care for CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A randomized trial in nephrology clinics and the community included 474 patients with median estimated GFR (eGFR) 42 ml/min per 1.73 m(2) identified by laboratory-based case finding compared care coordinated by a general practitioner (controls) with care by a nurse-coordinated team including a nephrologist (intervention) for a median (interquartile range [IQR]) of 742 days. 32% were diabetic, 60% had cardiovascular disease, and proteinuria was minimal. Guided by protocols, the intervention team targeted risk factors for adverse kidney and cardiovascular outcomes. Serial eGFR and clinical events were tracked.

resultsThe average decline in eGFR over 20 months was -1.9 ml/min per 1.73 m(2). eGFR declined by ≥4 ml/min per 1.73 m(2) within 20 months in 28 (17%) intervention patients versus 23 (13.9%) control patients. Control of BP, LDL, and diabetes were comparable across groups. In the intervention group there was a trend to greater use of renin-angiotensin blockers and more use of statins in those with initial LDL >2.5 mmol/L. Treatment was rarely required for anemia, acidosis, or disordered mineral metabolism. Clinical events occurred in 5.2% per year.

conclusionsPatients with stage 3/4 CKD identified through community laboratories largely had nonprogressive kidney disease but had cardiovascular risk. Over a median of 24 months, the nurse-coordinated team did not affect rate of GFR decline or control of most risk factors compared with usual care.

Indexed as

AgedBiomarkersCanadaCardiovascular AgentsCardiovascular DiseasesChi-Square DistributionChronic DiseaseCreatinineDisease ProgressionFemaleGeneral PracticeGlomerular Filtration RateHematinicsHumansHypoglycemic AgentsHypolipidemic AgentsBiomarkersCardiovascular AgentsCreatinineHematinicsHypoglycemic AgentsHypolipidemic AgentsPlatelet Aggregation Inhibitors

Identifiers

PMID21617090
PMCPMC3109918
OpenAlexW2170094063

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.